The Core Competencies:
Domain 7: Completion & Evaluation
A European Psychotherapist is competent to: -
- §7.1: Work towards a Completion of the Psychotherapy
- 7.1.1: Prepare for completion of the psychotherapy: which involves - discussing (at appropriate times during the course of the psychotherapy) the possibility of completion; helping the patient/client to review the process of the psychotherapy, in relation to their aims and goals at the outset and in relation to any subsequent changes in aims and goals; helping them identify achievements and/or avoid disappointments; working with the patient/client to identify when they may be ready to end the psychotherapy; assessing the readiness of the patient/client of moving towards a completion; helping the patient/client to remain aware of the inevitability of an ending of the psychotherapy sessions, and the implications of this; etc.
- 7.1.2: Explore feelings about endings: which involves – looking at feelings, anxieties and unconscious fantasies about ‘endings’, ‘loss’, ‘separation’ or ‘abandonment’; trying to avoid any ‘acting out’ or any premature ending; looking at the processes of ‘individuation’, ‘independence’, ‘autonomy’ and/or ‘self-regulation’; etc.
- 7.1.3: Identify any possible risks or difficulties: which involves – identifying when the individual is likely to be adversely affected by a termination of psychotherapy and any risks associated with this; looking at any transferential (and counter-transferential), any regressional, and/or dependency issues that might postpone (or hasten) the completion of the psychotherapy; examine any possible premature endings and any (unconscious) issues that may be behind these; considering the patient/client’s future post-therapy needs, their needs for any follow-up sessions, or their needs to maintain some form of non-, or less than-, therapeutic contact; discussing the implications of planned (or unplanned) endings with one’s supervisor, line manager, as appropriate; etc.
- §7.2: Manage the Conclusion of the Psychotherapy
- 7.2.1: Manage the conclusion: which involves – enabling the patient/client to experience an end to the psychotherapy that is (a) negotiated, (b) at a time when the psychotherapy is reasonably sufficient for them, (c) in a way that reasonably protects them (and others) from risk or harm, (d) that is, as far as possible, relatively free from any ‘counter-transferential’ influences about ‘loss’ or ‘endings’, (e) allows for any undisclosed material to emerge, and (f) allows ‘closure’ to unfold in an unforced manner; working collaboratively with the patient/client to identify a reasonably clear end to the psychotherapy; etc. (see also §2.4.3)
- 7.2.2: Review the process: which involves – enabling the patient/client to review their psychotherapeutic process over the course of the therapy and any hopes and plans for the future; discussing any changes in their perceptions of themselves and others, of family, cultural and societal structures, of power and self-esteem issues in relationships, and of issues of attachment and independence; coming to terms with any possible unresolvable issues that will probably not be concluded in this course of therapy; etc.
- 7.2.3: Identify issues, thoughts and feelings: which involves – discussing issues, thoughts, feelings and implications about other ‘endings’, ‘conclusions’, ‘separations’, or ‘terminations’, etc.; developing thoughts, plans and strategies for change with the patient/client, that take into account their current situation and relationships; exploring information about options for continuance of their process, possible referral, ongoing support and information, future therapeutic alternatives, should the need arise, etc.;
- §7.3: Record and Evaluate the Course of the Psychotherapy
- 7.3.1: Record the process of the psychotherapy: which involves – concluding (summarising), maintaining and storing clinical records in accordance with clinical, local, national and/or professional criteria; noticing and recording, in an appropriate way, any reduction of symptoms, other change indicators (stopping smoking or drinking alcohol, drug use, getting back to work etc.), any changes of circumstances, or satisfactory (or unsatisfactory) outcome as a result of the psychotherapy; etc.
- 7.3.2: Evaluate the psychotherapy: which involves – utilising any outcome assessments, client satisfaction questionnaires, follow-up studies, etc. to help evaluate the effectiveness (or efficacy) of the psychotherapy; writing a summary or case history, if appropriate; reflecting on the process of the psychotherapy and evaluating one’s own performance, issues and practice; and discussing with one’s supervisor, line manager or peer (intervision) group about any mistakes that might have been made, how they could have been avoided, the learning processes involved, and/or how any improvements could be made; etc. (see also §2.4.4)
Footnote:
[1] All these Core Competencies should be read in conjunction with the relevant sections of the EAP Statement of Ethical Principles (see Appendix 6 (see here) or the EAP website (see here)
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